What helps older adults with rheumatoid arthritis move from guided exercise to exercising on their own?

Details

Exercise supports health and disease prevention and is also an important part of managing chronic conditions, including rheumatoid arthritis (RA), an inflammatory joint disease. However, older adults with RA have lower physical activity levels than healthy older adults. This qualitative study explored aspects of participation in moderate- to high-intensity exercise with person-centred guidance that influenced older adults with RA as they transitioned to independent exercise.

This was a qualitative interview study. Researchers conducted in-depth interviews with 16 adults with RA aged 68–75 years who had participated in the intervention arm of a randomized controlled trial involving moderate- to high-intensity exercise with person-centred guidance. The interviews were analysed using qualitative content analysis.

The analysis identified six main categories: a feasible opportunity to adopt exercise; experiencing positive effects of exercise; contextual factors affect the experience of exercise; developing knowledge and thinking; finding one's way; and managing barriers for exercise. Participants described exercise with person-centred guidance as a feasible opportunity to begin exercising, providing a basis for moving to independent exercise. They described developing knowledge and thinking about exercise during the intervention that enabled them to manage this transition. Finding their own way to exercise became important for sustaining independent exercise. Participants also described barriers to exercise and strategies for overcoming them. Temporary and permanent reductions in physical health were described as a considerable barrier to exercise.

The researchers concluded that participants described several aspects of exercise participation that influenced and facilitated their transition to independent exercise. With a careful introduction and an individual exercise routine developed in partnership with a physiotherapist, exercise was experienced as manageable and positive. This seemed to support the development of self-efficacy, which was important for future independent exercise. The conclusion reiterated that reduced physical health, whether temporary or permanent, was a considerable barrier. The personal process of making exercise one's own, developing exercise knowledge, and forming new thoughts about oneself seemed to prepare participants to manage independent exercise and overcome barriers.